Competency to Stand Trial

Persons accused of criminal activities must be competent to stand trial; that is, must be capable of understanding the purposes and aspects of the legal proceedings held against them and must have the ability to contribute to their own defense. The mental capability of the accused only matters during the period of time it takes to prosecute the person, as the act of taking legal action against a debilitated person is a violation of the U.S. laws of due process. According to the justice system, any accused person who becomes mentally incompetent before or during the events of a legal proceeding, including after a conviction is made, may not be subjected to the criminal penalties and punishments implemented by the court. However, the accused and/or convicted person may be held and confined to a mental hospital or facility for their own protection and for the protection of the general public.

When determining the competency of a person to stand trial one psychiatrist (or several psychiatrists with different concentrations) may be used to decide if the accused is competent. A psychiatrist will consider several psychological disorders when determining a person's mental state. The major disorders that are generally considered include: (1) mental retardations (often caused by congenital conditions, brain injuries, or infections), (2) neuroses (repeated anxiety, depression, and various maladjustments, but without psychotic symptoms), (3) organic brain syndromes (physical defects or diseases such as those found within elderly persons in the form of, for example, hardening of the arteries and within the general population in the form of, for example, brain tumors and multiple sclerosis), (4) personality disorders (inabilities to conform to socially accepted behaviors such as antisocial personality), and (5) psychoses (derangements of personality and loss of contact with reality such as with manic depressive illnesses).

The examination performed by the psychiatrist on the accused includes a physical examination (to learn about behavior, emotional state, and general appearance), a check of family and personal background (to identify mental illness history), psychological tests (to show specific mental states, including intelligence tests and psychomotor tests for conceptual thinking and memory), and personality tests (to detect the presence of psychopathologic characteristics). The psychiatrist also possesses the ability to use the concept of diminished responsibility (sometimes called diminished capacity or partial insanity). The concept permits the justice system to take into account the impaired mental state of the accused even though the specific impairment does not qualify as being incompetent to stand trial under the tests performed by the psychiatrist.